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SAFE-T tool validation: An inpatient shift-based screening tool for infant safe sleep
Jennifer Gingrasfield1, Alexandra Cole2, Michele DeGrazia3
1Sleep Center, Boston Children's Hospital, Boston, MA, United States of America; Pediatric Hospital Medicine, Boston Children's Hospital, Boston, MA, United States of America.
Insights
Sudden unexpected infant death is a leading cause of infant mortality. The SAFE-T tool was validated to improve infant safe sleep knowledge and practices in hospitals, promoting safer sleep environments for infants.
Area of Science:
- Pediatrics
- Public Health
- Healthcare Quality Improvement
Background:
- Sudden unexpected infant death (SUID) is a critical public health issue, accounting for over 3500 infant deaths annually in the US.
- Knowledge and practice gaps in infant safe sleep are prevalent in inpatient settings, necessitating targeted interventions.
- Existing screening tools may not adequately address the complexities of safe sleep practices within a hospital environment.
Purpose of the Study:
- To modify and establish the content validity of the Safe Sleep Screening Tool (SAFE-T), an inpatient shift-based screening tool.
- To develop a reliable instrument for assessing and promoting safe sleep environments for infants in healthcare settings.
- To address the need for standardized tools to improve safe sleep knowledge and practices among healthcare providers.
Main Methods:
- A national sample of hospital-based infant safe sleep program professionals participated in e-Delphi rounds.
- Surveys were used to gather feedback on the original tool items and modified versions.
- Consensus was defined as 80% agreement on tool items, with iterative revisions based on participant feedback.
Main Results:
- Thirty-two professionals from 28 institutions participated, with 78% retention across three survey rounds.
- The SAFE-T tool underwent modifications to its items, introduction, and reference materials based on expert feedback.
- The final tool features 14 response options, refined from the pilot tool's 15, and two domains were renamed for clarity.
Conclusions:
- The SAFE-T tool is the first validated inpatient shift-based screening tool designed to promote safe sleep practices.
- Implementation of the SAFE-T tool in hospitals has the potential to enhance safe sleep practices during hospitalization and post-discharge.
- Further research is recommended to assess the tool's impact on caregiver behaviors after hospital discharge.
Objective:
Sudden unexpected infant death (sudden infant death, sleep environment death) is the leading cause of mortality for infants aged 1-11 months and contributes to >3500 deaths each year. Infant safe sleep knowledge and practice gaps exist in many inpatient settings. The purpose of this research was to modify and establish content validity of an inpatient shift-based safe sleep screening tool (SAFE-T).
Patients And Methods:
e-Delphi rounds were conducted with a national sample of hospital-based infant safe sleep program professionals. The first survey included questions on the original tool items developed and pilot tested by institution-based providers. During subsequent e-Delphi rounds, participants were sent the modified tool items and additional questions. Items with 80 % agreement were considered to have reached consensus and retained. Items that did not reach consensus or received substantial feedback were included for consideration in the next e-Delphi round.
Results:
32 professionals from 28 unique institutions completed the demographic survey and participated in the research. There was 78 % participant retention during three survey rounds. Modifications were made to the tool, its introduction, and reference materials based on participants' feedback. Two of the five domains required renaming, and the potential responses to the pilot tool were 15 compared to the final tool, which has 14.
Conclusions:
The SAFE-T tool is the first validated inpatient shift-based screening tool designed to facilitate safe sleep practices. Implementing the tool in the inpatient setting could help improve safe sleep practices while infants are in the hospital and after being discharged home.
Implications For Practice:
The SAFE-T tool could be implemented in hospitals where infants receive care. By supporting consistent safe sleep modeling by nurses and other providers in the inpatient setting, the tool has the potential to promote improved safe sleep practices when infants are discharged home. Future research should evaluate the tool's impact on caregiver behaviors after discharge.
